An Almost Pathological Degree
by winter machine
Summary: "Come on, Derek. Everyone sleeps with Mark." Summer's request for Mark/Kathleen, with a helping of Mark/Addison. Pre show.


**_My four-hundred-dollar-an-hour shrink says that it's because behind this rugged and confident exterior, I'm self-destructive and self-loathing to an almost pathological degree._**

(Mark Sloan, "Yesterday")

**_Come on, Derek. Everyone sleeps with Mark._**

(Nancy Shepherd, "Let the Angels Commit")

_**Kathleen's the shrink, Nancy. Not you.**_

(Derek Shepherd, "Let the Angels Commit")

* * *

The first time, he announces himself just by barging into her admittedly open door.

(She's the middle of three girls, the second of five, the peacemaker and the caretaker and she knows a closed door is more of an invitation than a cracked one.)

"Hey Kath, what are you doing?"

(He's an only child, a firecracker and an observer all at once and he practically lives over here but still hasn't internalized the tricks of big family living like she has.)

"Studying." She sighs, doesn't look up. Coming back home for Easter means blocking out a good deal of distractions to get her pre-finals studying done. There's the mother who's always asking questions and the father whose absence is even louder, two chatty sisters and one sullen one, the brother who ignores her and the surrogate brother who doesn't.

"Psych?" He reaches for her notecards and she pulls them out of his grasp, well practiced at avoidance.

"Mark, I'm trying to work."

"Maybe I can help," he offers and she rolls her eyes at his boastful tone. Overconfident, as always. A funny pairing for her awkward little brother, but they've always gotten along so well.

"You're barely even in college, Mark."

"I'm pre-med," he reminds her. "And I'm nineteen."

"A fetus," she dismisses and he scowls.

"Shut up, Kick."

"Make me." She tosses down the notecards, surprising herself. There's a warm breeze coming in the open third-floor window. It's moving the hair off her neck and it makes her feel bold.

"Nah." It's his turn to sound dismissive. "Too easy."

"Mark!" She is offended in spite of herself and he turns, catching her in the very moment she realizes she's caught - literally. Her hand is trapped in his and his thumb traces over the veins at the inside of her wrist. For a minute they just eye each other, a dare posed and a challenge accepted.

He breaks the silence: "Why would you want to study psych anyway?"

"It's interesting. It's - what are you doing?" she whispers, because his thumb is moving higher, in agonizingly slow circles.

"Feelings," he says as if the word tastes bad. "Thoughts. Whatever. There's just...so many more interesting things about the _body_, you know?"

"I don't..."

Then she stops talking, because he keeps moving closer, and the scent of him is curling around her. He smells like outside, like he's been standing under the pine tree in the yard, all mixed up with something male, an almost dangerous mixture.

Then he locks her bedroom door and she wonders if the sound of the latch sliding into place will forever bring the same rush of fever to her belly. Her heart is leaping against her breastbone, her pulse throbbing inside her mouth, between her thighs, behind her eyes.

It's dead quiet in the room now, the faint buzzing of her light, and the birds outside singing merrily as if they know better.

Maybe they do. There's so much it turns out she doesn't know. She had no idea, for example, that the inside of her elbow was an agonizing network of nerve endings, that when his lips skim the soft bit of shoulder where it dips into her arm it would send sparks shooting from her navel to her knees.

"Mark..."

And she doesn't know why it's the soft underside of her breasts that aches with slow fire when his tongue traces their swell. Her second rib is more sensitive - this, too, she discovers when two fingers skim over it while his lips circle the plane of her belly.

"Did you learn about this in psych?" he asks innocently, as his teeth close with barely any force - just enough to make her moan - and she arcs away from him, using the last of her reserves to bait him.

"Did _you_ learn it in pre-med?"

He kisses her instead of answering. Wherever he's learned this it's effective. She's forgotten everything now: the notecards she had been painstakingly printing, the fact that she's pretty sure Nancy has a crush on him, even if she'd never admit it, the boyfriend she left behind in Philly and the simple oak door separating this room from the rest of her boisterous family. He's stroking her deftly, like he's been doing this for years - knowing Mark, he has - but with the enthusiasm that screams _nineteen_ as clearly as a letter jacket. She gets the sense he can make things happen, that a morning spent studying while her mother boils a ham and her baby sister pretends to care about hidden eggs can turn into something entirely different under his hands.

Around his fingers.

She's convinced she's stopped breathing. The high pitched noises that were whining at the back of her throat have congealed into something else entirely, and there are black spots dancing before her eyes. When he pushes into her she's hanging off her bed, half upside down, long hair brushing the stiff purple carpet Maria picked out first. It's a child's room, trophies and stuffed animals and relics of embarrassment everywhere. She wraps her legs around his hips and holds on for dear life, not sure if falling or staying up is the more terrifying prospect. He eases her back onto the bed when he's finished, with a casualness she's not sure she could ever fake.

When she opens her eyes he's looking at her and she tries to read his expression. He's running his hand gently over her trembling thighs and she realizes maybe they are trying to read each other. That this is how he speaks. That she can spend the rest of her life trying to understand what's happening behind pale blue eyes and a cocky grin and never quite figure it out. There's enough there to keep her busy. To keep her guessing. Let him have the body; she knows what she wants. When she gets her breath back she smiles at him.

"Thank you," she says, sincerely, though she doesn't specify for what.

* * *

The next time is years later and it's in the form of a disembodied voice. He calls her at three in the morning; bleary and sleep-soft, she rolls away from Nick, assuring him everything's fine, to whisper fiercely into the receiver. "What's going on?"

"It's Amy, Kick."

"Did something happen?" She sits up in bed, Nick's hand flying away from her as she does. "She's still in-" all that expensive training and she can't say _rehab_.

"Yeah, she's there. No visitors for thirteen more days, remember?"

Of course she remembers. She's the shrink so they all _looked _at her when Amy was screaming, ranting, a fistful of pills and mouthful of bile, Addison crying and her mother wringing her hands. Nancy was stony silent, Maria a clone of Mom as usual. Kathleen was supposed to have answers.

"I should have said something."

"Said - what?" She swings her legs out of bed, throwing an apologetic glance over her shoulder at Nick, who's already falling back to sleep. "Mark, what are you talking about?"

"I knew."

"You knew-"

"I saw her. But she said she was going to stop, and..."

It's nothing she hadn't suspected. "Mark," she says carefully. "This is not your fault."

He pauses. "Does this count as shrinking?"

"No." She half smiles into the phone. "No. I mean, I'm not going to charge you."

"Can I even afford you?"

"My rates are lower for family," she teases, but she hears his voice catch in his throat when he tries to respond. "Mark," she starts gently - she wasn't trying to upset him - but he speaks over her, quick and loud.

"Look, sorry I woke you. And, you know, thanks. See you, Kick."

"Mark-"

But he's already hung up.

* * *

Yet another time, he's just _there_, in her doorway, filling it up with his broad shoulders and the easy - if forced - smile of a man who's not used to being unwelcome.

She asks anyway: "What are you doing here?"

"I had to track down your new office. Nice digs," he whistles.

"Thank you," she allows. "But really, Mark, I have patients-"

"So have me."

"Excuse me?"

"I can be a patient."

"I charge, Mark. I charge rates commensurate with my training, I - stop looking at me like that." She narrows her eyes but can feel herself starting to relent - embarrassingly, it starts somewhere south of the chain-link belt looped across her conservative trousers.

"I can afford it." He shrugs, leather jacket sliding off his shoulders like a turtle's shell, and out he pops.

"Fine." She sits back down. Four hundred dollars an hour. Mark's certainly spent more for less. She picks up her pad, lets the pen poise itself over the paper. "So. Who did you sleep with this time?"

"Your sister-in-law."

"Janet?" she squeaks. Nick's sister isn't exactly Mark's type. Then again...

But he shakes his head.

"What, then - Mark, you can't be serious."

He just looks at her.

"Does Derek-"

He nods.

"Oh, Mark."

For a moment they just regard each other. She breaks the silence this time: "What happened when Derek-"

"I don't even know."

"What do you mean?"

"She threw me out." He shakes his head slightly. "He didn't say one word when he saw us, he just turned and walked away - and she asked me to leave and I did."

"You left?"

He's looking out the window into the soft dusk, with that purpling-bruise look the east side sky gets just before sunset. "She asked me to."

Kathleen shakes her head. Excluded from the denouement of his own disaster. How very like Mark to be the architect of the end of the marriage and yet deprived of its final chords. This is somehow far more interesting to her than the actual end of the marriage - she's a psychiatrist, after all, and she's a middle child, and she's a wife and she's a woman. Two of those things would be enough to have seen this coming, to recognize in her sister-in-law's pleading eyes and her brother's indifferent expression that they were headed nowhere fast. Still, piloting that doomed plane is a bit much, even for Mark.

"Is this really true?"

"Would I lie to you?"

She doesn't answer.

"I guess you haven't heard from Derek," Mark says finally.

"It's not Christmas or my birthday," she answers like a sister. "Why would I?"

"I don't know where he is."

"Have you tried to reach him?"

"Of course. Called, emailed - he's ignoring me."

"What about Addison?"

For a minute he just looks at her. Then he says: "She showed up at my apartment yesterday with this - bleached blond hair."

Kathleen's silent for a moment, trying to picture it.

"She was crying. She said Derek wouldn't return her calls."

"So what did you do?"

"I slept with her," he says easily.

* * *

But the last time, he walks into her office without a word. When the silence grows too loud to bear, he mutters just two words, eyes on the thick cream-colored carpet the decorator promised her would have a calming effect on her patients.

"She's gone."

Kathleen leans forward. "Go on."

"She went to Seattle."

"Seattle..." she prompts. It doesn't ring a bell.

"Derek's out there, apparently."

Oh. Nice of him to tell any of his sisters. She just talked to Nancy yesterday, and - but this isn't about her. "Look, Mark-"

"Kath, we have doctor-patient confidentiality, right?"

"So you're my patient now?"

"Are you my doctor?"

He drops his head into his hands, suddenly. No warning. She feels a stirring in her stomach. His pain is as ugly as her long-ago need and it leaves her feeling just as inadequate. "Mark..."

"She got rid of it," he mumbles into his palms.

"Got rid of what?"

"The baby."

She swallows her gasp in a professional nod.

"Where is she?"

"With him, I guess."

"Derek?"

"Yeah."

"And how does that make you feel?" She says it without thinking, daringly, half to make him smile.

His glare is dangerous though, so she switches tactics. "Why did she leave, Mark?"

"I don't know."

"Yes you do."

He scowls.

"Who were they, Mark?"

He's still glaring, but he ticks them off on his fingers. "A tennis instructor at the club. The barista with the pierced - and my downstairs neighbor. And a psych resident." He looks at her in a way she doesn't want to explore when he says that. "And two nurses. She caught me with the last one."

"Mark..."

"Don't judge me."

"I took an oath," she offers.

"She wouldn't take off her rings."

"Mark-"

"And she wouldn't sign the papers."

"What did she do when she walked in?"

"Walked right out again." _Like Derek_, she thinks. "Like Derek," he adds after a moment, and she nods as if he thought of it.

"And what did you do?"

"It was just sex. I told her, but-"

"What is sex to you, Mark?"

"What do you mean?"

"A weapon? A skill? What?"

"No, nothing like that. It just _is_," he shrugs. "Like-" he sighs instead of finishing his sentence, so she finishes it for him (not in the shrink code, as her colleagues might say, so she just does it in her head) - _like breathing._

"We could have been a family. If she stayed, if she..."

He trailed off and she pushes the tip of her pen into her mouth to stifle her first response.

"But she left."

"Because I cheated, but I would have stopped if-"

"Have you ever?"

"Ever what?'

"Stopped cheating."

His brow furrows. "What do you mean?"

"I mean, have you ever been faithful? Monogamous?"

"I could have been." His tone is stubborn.

"Mark, what makes this different from-"

"Because I wanted to!" he explodes. Then he looks away, embarrassed. "I wanted to, okay?" He tells it to the twinkling city lights outside instead of to her.

_Oh. _"You actually have-"

"Don't say it."

"_-feelings_-"

"I just told you not to say it."

"-for her."

They regard each other in stony silence.

"Shut up," he says finally, and he's fifteen again.

"Shrinks don't shut up," she teases back.

"So now you're my doctor?"

"If you're still my patient."

And here they are. Detente, tug of war, splitting a wishbone. And the only reason she knows her brother is in Seattle is because of this man. Her sister-in-law has disappeared from her life and it's him - it's Mark - he's the hub of the Shepherd spokes, and when he spins out they do too.

"Mark..."

"I screwed up."

There's still some rain on the collar of his jacket. She watches one drop roll off the fabric like a tear. She taps her pen on her pad, his misery a living, breathing thing in the room with them.

"Why?"

"Why what?"

"Why did I fuck everything up?"

She shakes her head. "You're self-destructive."

"I could have told you that. I'm not a shrink, just a fuck-up."

"And you're self-loathing."

"Everyone's self-loathing."

"Not like you." She sets down the pad. "Behind that-" she waves her hand vaguely "-_exterior_, you're self-loathing and self-destructive to an almost pathological degree."

He opens his mouth and she thinks for a moment he's going to protest.

"If you can learn to forgive yourself, and it's certainly a process that's going to require - Mark, what are you doing?"

The o of his lips moves closer, his warmth pressing against her.

"Mark," she whispers again. "What - what are you doing?"

His words are very near her ear now, moist and making her jump. "Destroying myself?"

"_Mark_." She sharpens her tone.

He spreads his hands. "You said it. I'm flawed. I'm a wreck. But you-"

"I'm your shrink."

"Right." Somehow his hands have worked their way inside her cardigan, thumbs warming her ribs through the fabric of her silk blouse. "That's what I was going to say."

"Mark..."

"My shrink."

"We shouldn't do this."

"Why? You're divorced."

"Separated."

"Whatever."

"Mark..."

He leans forward, forehead against hers, and she closes her eyes. This close, she can make out the individual golden bristles on his jaw. He hasn't shaved today, clearly. His oversized hands are moving slowly, confidently, from the dip of her waist to the curve of her ribs. He touches her like he remembers, this body that sometimes seems foreign to her. Three children later, nothing is in the same place it was that long ago Easter. The light is soft, expensive, but still clinical, and her face flushes to think of the aging skin beneath the silk. The flush extends form cheek to jaw to neck as his lips trace a path along her exposed collarbones.

He doesn't ask a question, and she doesn't say _no._

He moves within her slowly, carefully, looking at her like he means it. She thinks it would hurt less if it were fast, if he shoved her against the wall of her office like she'd fantasized more than once, on hot sticky slow evenings of other people's problems. He'd push her into the delicate eggshell paint - high gloss, extra soothing - and her diplomas would clatter to the floor. Broken glass, shattered stories.

She says his name again and that's when he looks away.

"You did love her," she whispers. He's staring out the window. Her thumb, almost of its own accord, extends to his cheek and brushes the damp skin there. "Maybe you still do."

He closes his eyes, lashes damp. "Shut up, Kick."

But his face is wet with more than perspiration. The shrink in her observes it clinically. The rest of her sets it aside, reaches only for the parts of him she can. Sex is like breathing for him, after all, and she's a doctor. He resuscitates under her hand.

"You're wrong. I don't love anyone," he mutters into her hair as she slides a leg over his.

She answers his lie with one of her own, lips on his cheek: "It'll be okay."

* * *

_Reviews are warmly welcomed and always appreciated._


End file.
